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Unlabelled: There are over 400 hotels in Milan with a guest capacity of about 62,000 and employing more than 10,000 workers. In 2008/09 the Occupational Health and Safety Service of A.S.L. Milano (Local Health Unit) carried out research into the hotel trade to ascertain the development of this commercial sector, also in view of EXPO 2015., Objectives: The aim of the project was to improve hygiene and safety conditions and carry out preventive measures. A specific purpose was to study manual handling of loads and repetitive movements risk., Method: The study covered 30 hotels and 7 temporary staff cooperatives. We acquired the Risk Evaluation Document, the Health Surveillance Programme and Registers of Labour Accidents to analyze manual handling of loads and repetitive movements. In the investigations and assessments on hotels we used currently available scientific tools--NIOSH Lifting Index, Push and Pulling Analysis, OC.R.A. Check-List--to study risks related to handling loads and upper limb mechanical overload, which revealed a specific occupational risk that requires a fresh approach to prevention and safety in the entire sector., Results: Chambermaid: LI (Range): 0.57-2.75; Push and Pulling Actions: Fi 0.66-Fm 1.5 and Fi 0.76-Fm 1.33 respectively; OC.R.A. Check-List: 21. Porter: LI (Range): 0.77-3.75. Maintenance staff LI (Range): 0.57-2.75., Conclusions: The study highlighted the presence of risk due to manual handling of loads and repetitive movements in porters, maintenance personnel and particularly in chambermaids that up to now have been poorly assessed by safety experts. Analysis of the information contained in the registers of labour accidents suggests that a significant number of accidents can be related to muscular-skeletal disorders that affect especially cleaning, portering and kitchen staff